Geriatric dentistry: a changing paradigm.

VOLUME 45 • NUMBER 4 • APRIL 2014 The practice of dentistry has changed dramatically. Technology, patient expectations, life expectancy, dental therapy, and the internet have had a profound impact on the dentistry of today. Baby boomers are living longer and are more affluent, better educated, and living healthier and more productive lives. Unlike previous generations, they have benefitted from the advances in oral care, preventive dentistry, and diet, and consequently have retained their teeth. This population continues to seek quality and often complex dental therapies. Implants are commonly placed in individuals aged 60 and over. The management of the aged population has received little attention. As stated by Dr Muller deVan, “We must meet the mind of the patient before we meet the mouth.”1 We must develop more objective and patient-centered evaluation criteria to meet their treatment needs. The geriatric patient may have psychologic and physical challenges unrelated to dental and oral conditions which require creative solutions to meet their needs and create a sense of well-being. The infirmities of age may also be exacerbated by the presenting oral conditions. Complex treatments that require greater effort on the part of the patient for home care and management may not be appropriate. The prognoses for restorative therapies for the geriatric patient, which range from the simple Class 2 composites to the full mouth rehabilitation, require reevaluation. More objective and patient-based evaluation criteria must be applied2 because the impact of restorative procedures on quality of life is an important consideration for the geriatric patient.3 Geriatric dentistry: A changing paradigm